Tick, Tick, Tick

Will The Baby Boom Generation Stand Still For Menopause?

February 24, 1991|By Beth Austin.

The women of the Baby Boom grew up thinking none of the rules applied to them-at least, none of the sexual ones. When they came of age, the Pill offered them sexual freedom without pregnancy, and legal abortion provided a safe backup to contraceptive failure. When they put off having children until their late 30s, fertility drugs and high-tech fertilization procedures helped them to ignore the ever-louder ticking of their biological clocks.

But now those Baby Boom women are facing menopause, and they`re learning that some of nature`s rules were made not to be broken. Every woman who survives past her 40s must go through menopause, ready or not.

As expected, Baby Boom women are not facing menopause quietly, and they already are marking their path to midlife with a substantial paper trail.

This is, after all, a generation that has grown up by the book, from Dr. Spock through ``Our Bodies, Ourselves,`` all the way to the current avalanche of self-help volumes overwhelming library shelves.

So it`s no surprise that a slew of books on managing menopause already is in print, with more on the way as the Boomers hurtle unwillingly into their mid-40s, desperately seeking a way to slow the relentless march of time.

Although the Baby Boom generation believes it invented sex, hallucinogenic drugs and rhythmic music, it actually is creating something new under the sun only as it reaches healthy middle age.

In the early 1900s, a woman`s average life expectancy was about 40 years, 11 years earlier than the average age of menopause. Since then, women`s life expectancy has doubled, and population studies predict that, by the end of this century, more than one-third of American women will be past menopause.

Some researchers believe women fear menopause because, until just recently, it signaled the coming of death. But as Baby Boomers bone up on menopause and its symptoms-which can include hot flashes, vaginal atrophy, depression, anxiety, memory loss and nervousness-they may consider it a fate worse than death.

Biologically, a woman`s fertility begins declining in the mid-30s. By the time she reaches her mid-40s, the gradual process leading to menopause is already well under way, although her menstrual periods may continue into her 50s.

As Baby Boomers are learning, the alarm is set differently on each woman`s biological clock. Most women are born with a full complement of 2 million ovarian follicles. About 300 to 400 follicles ripen into eggs over a woman`s reproductive life; the others simply atrophy. As the ovarian follicles wither with age, the amount of estrogen they produce declines.

The age at which this process begins varies from woman to woman;

generally, the younger she was when menstruation began, the longer it will continue.

The first sign of coming menopause is a rising level of follicle-stimulatin g hormone (FSH), the chemical that triggers the monthly

development of an egg. In younger women, the follicle-stimulating hormone is countered by a rise in estrogen, which helps the egg to mature. But as a woman approaches menopause, usually after age 45, the estrogen response to the follicle-stimulating hormone changes and the menstrual cycle shortens.

A woman whose menstrual cycle is changing and who wonders whether menopause is near can ask for a blood test: Unusually high levels of the follicle-stimulating hormone will signal that the body`s estrogen response is starting to shut down. Smoking, which can affect the body`s estrogen levels, seems to hasten this process.

As the ovaries stop functioning, a woman goes through what best can be described as ``estrogen withdrawal.`` (That description actually is quite appropriate: Estrogen affects about 300 of the body`s tissue receptors, many of which also are affected by opiates; so many menopausal symptoms are similar to those suffered by addicts withdrawing from heroin.)

Before entering into 50th-birthday suicide pacts with her women friends, however, the Boomer facing menopause can take comfort from another friend, medical science, which is leaping into the breach to spare her Nature`s worst. Managing menopause

Many of the new books on menopause tout the benefits of hormone replacement therapy (HRT): small amounts of estrogen, usually taken orally or via skin patches, to ease the worst symptoms of menopause.

Estrogen therapy usually halts hot flashes, and it also brings the vaginal tissues back to normal (although most vaginal problems can be solved by direct application of estrogen cream). Regular doses of estrogen also seem to protect against heart disease and osteoporosis after menopause.

Most of the new menopause books push estrogen therapy because most are written by doctors. And most of the medical community view menopause as an estrogen-deficiency disease that must be cured.